Berger D, Richard H, Grall J Y, Levêque J, Giraud J R, Palaric J C, Poulain P
Service de Gynécologie-Obstétrique, Hôpital Sud, Rennes.
J Gynecol Obstet Biol Reprod (Paris). 1991;20(1):116-22.
The authors present their results as far as successful vaginal delivery (in 39.9% of cases) carried out in 884 cases with a scar in the uterus. They also give the morbidity and maternal and fetal mortality as well as those that developed a rupture of the uterus. No mother died in their series and there was no fetal death that could be ascribed to a complete rupture or a uterine dehiscence. Both fetal and maternal mortality was considerably higher when the trial of scar failed or when a Caesarean section was carried out prophylactically, as compared with the results from vaginal delivery. 2.17% of all the 884 patients with a uterine scar had a complete or incomplete rupture of the scar. Finally the describe their criteria for selecting patients for attempts at vaginal delivery and they show that it is necessary to test the ability of the fetus to pass through the pelvis after looking very carefully at the partogram made for the previous Caesarean operation. In this way they were able to use a trial of labour in slightly contracted pelves or where the fetus was big in such a manner as to obtain a vaginal delivery in, respectively, 68 and 72% of cases.
作者展示了在884例有子宫瘢痕的病例中成功进行阴道分娩（占39.9%）的结果。他们还给出了发病率、孕产妇和胎儿死亡率以及发生子宫破裂的情况。在他们的系列病例中没有母亲死亡，也没有可归因于完全破裂或子宫裂开的胎儿死亡。与阴道分娩的结果相比，当瘢痕试产失败或进行预防性剖宫产时，胎儿和孕产妇死亡率都显著更高。884例有子宫瘢痕的患者中，2.17%发生了瘢痕完全或不完全破裂。最后，他们描述了选择尝试阴道分娩患者的标准，并表明在仔细查看上次剖宫产的产程图后，有必要测试胎儿通过骨盆的能力。通过这种方式，他们能够在骨盆轻度狭窄或胎儿较大的情况下进行试产，分别在68%和72%的病例中实现阴道分娩。
